Behavioral Health Medical Directors, Researchers, FBI agents, Judges, and Law Enforcement spent months examining the connections between mental health and mass shootings. In August 2019, they published their findings: these connections are much more complicated than simple cause and effect.

The report considers a wide cross-section of mass violence, including 160 active shooter incidents over a decade from the FBI, U.S. Secret Service information on 28 mass attacks on public spaces in 2017, and 37 incidents of school violence from 1974 to 2000. It concludes that blaming mental illness as sole cause of a mass shooting is inaccurate.

"'If we simply focus on mental illness, we can eradicate mass shooting.' You know it's just misinformation. It's incomplete," Dr. Donald Bechtold, Medical Director and VP Health Care & Integration at the Jefferson Center for Mental Health told Newsy. Bechtold served as an editor on the expert panel for this report.

"On the one hand there's mental illness. And on the other hand if there's mental-not wellness and the two are different you know mental illness is the presence of a negative if you will. When you look at these incidents you know no one would say that an individual who commits mass murder perpetrates mass violence. Nobody would say this is a normal individual, a psychologically healthy individual, he said.

"That's where the mental health not wellness comes in. You know there's a lot that's gone on developmentally with these folks that have things that ought to be protective factors for them simply aren't and things that ought not to be risk factors for them are risk factors."

Even research-data definitions aren’t universal for mass shooting or mental illness. The report calls mental illness an "elastic" term. It's defined in different ways in different cases, which makes it hard to measure its exact impacts on violence. Depending on how it was defined, mental illness was present in anywhere from less than 5 percent to more than 70 percent of mass violence cases.

"They weren't all using the same definition of mass violence," explained Dr. Joe Parks, Medical Director for the National Council for Behavioral Health. "They weren't all using the same criteria for what incidences to include and which was to exclude some use a different number of people killed three versus four people killed others would exclude incidences that involve the death of people the perpetrator knew they would only do involving stranger some only included guns and not other causes."

"The second thing that very widely was what. How do they define what they meant by mental illness. So the low number under 5 percent is the definition of mental illness used for the National Instant Criminal Background Check: the watch list that used to deny people guns. The biggest number was the rate of people who appeared to have some kind of emotional distress," Parks said.

There are commonalities between shooters, however. According to the report, the majority of mass shooters are male and tend to racially and ethnically mirror the U.S. population. They are also often hopeless and resentful about work, money, or interpersonal relationships, and are "indifferent to life and often subsequently die by suicide."

To get a more complete picture, the panel suggested that all government agencies share standard definitions for the study of mass violence, and detail what it means to have a mental illness or not have mental illness.

Experts suggest individuals take Mental Health First Aid classes – government-backed 8 hour courses that teach people how to identify different mental health conditions. The panel also recommended the government provide resources for a national registry to track mental illness, much like how the CDC tracks every Ebola case or measles case. And they say the government should consider red flag laws, to temporarily remove guns from individuals who pose a high risk of harming others or themselves.

"This isn't about mental illness. This is about a social illness that's characterized by hatred and anger and what are we going to do as individuals each of us to reduce the hatred and anger in our communities," Parks said.

Bechtold echoed the need for the conversations of mental health and mass shootings to move beyond a political talking point.

"If you think of kind of the current narrative 'oh this is mental health,' what happens then some people take that, they misinterpret it. They think every individual with mental illness is dangerous. They're afraid of them. They enhance stigma. These folks become more peripheral in their lives, marginalized. Even very basic rights may be taken away unnecessarily from these folks. All because, not that the basic point that there's an association is wrong, but that the depth and breadth of the association is greatly overstated and overly inclusive," he said.